INS and Large for gestational age: In 10 studies including 1,810 women [31,33,34,40,41,42,44,45,54,56], metformin-exposed neonates had reduced rates of macrosomia compared to insulin-exposed neonates (OR 0.60, 95% CI 0.45 to 0.79, I2 = 5%, p < 0.001) (Fig 4B).